Abdominal Wall Chronic Pain

Chronic abdominal pain of unknown etiology is not a rare cause of patient’s complaints.

Diagnostic procedures are time-consuming, expensive and often do not explain the cause of problem. According to the literature the visceral pain sometimes may be mistaken for the abdominal wall pain.

Very useful in differentiating between visceral pain and abdominal wall pain is the Carnett’s Test. During examination for Carnett’s sign the doctor identifies the point of abdominal pain by deeply palpating with his finger. The patient then tenses the abdominal wall while the fingertip is released. If the pain gets stronger after muscle tension it is highly likely that the source of pain is the abdominal wall nerve impingement or hernia. Others helpful procedures are ultrasound examination and abdominal wall block. The abdominal wall block is positive when pain gets better after anesthetic injection into the abdominal wall. The procedure should be done under ultrasound guidance. The treatment of abdominal wall pain is a perineural steroid injection or a nerve hydrodissection.

Dr. Marcin Goczewski performs the diagnostic block, steroid injection and the nerve hydrodissection only under ultrasound guidance.